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English (US)
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We’re excited to have your child join our Campessori Summer program! Please complete a separate registration form for each child you're enrolling, and we’ll take care of the rest.
Which schedule would you prefer for the Campessori Summer program?
*
April 21 - May 3, 2025
May 12 - May 23, 2025
Who is filling out this form?
*
First Name
Last Name
Email
*
Confirmation Email
Please input you email twice for confirmation.
Mobile No.
Address
*
Street Address
Street Address Line 2
City
Relationship to Applicant(s)
Father
Mother
Guardian
How many child(ren) are you applying?
*
1
2
3
Today's Date
*
-
Month
-
Day
Year
Date
Back
Next
Child Applicant
First Name
*
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Age Child 1
Depending on your child's date of birth, their assigned level is:
Gender
Male
Female
Weekly schedule preference:
*
3 days a week
5 days a week
Is your child currently attending therapy OR has your child been recommended for therapy?
*
Yes
No
If you answer 'Yes', please select the relevant option and provide a brief explanation in the comment box below.
Developmental Delays
ADHD
ASD
Others
Comment box:
Amount Due Child
First Name
*
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Age Child 2
Depending on your child's date of birth, their assigned level is:
Gender
Male
Female
Weekly schedule preference:
*
3 days a week
5 days a week
Is your child #2 attending therapy?
*
Yes
No
If you answer 'Yes', please select the relevant option and provide a brief explanation in the comment box below.
Developmental Delays
ADHD
ASD
Others
Comment box:
Amount Due Child 2
Child Applicant 3
First Name
*
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Age Child 3
Depending on your child's date of birth, their assigned level is:
Gender
Male
Female
Weekly schedule preference:
*
3 days a week
5 days a week
Is your child #3 attending therapy?
*
Yes
No
If you answer 'Yes', please select the relevant option and provide a brief explanation in the comment box below.
Developmental Delays
ADHD
ASD
Others
Comment box:
Amount Due Child 3
Grand Total
Please review your answers before clicking submit. Thank you.
Submit
Should be Empty: